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Home My WebLink AboutPermit Building 1985-8-5 y .' r ., . CITY Of SPRINGfiELD COMBIIIATION APPLICATION/PERMIT EUERGY SOURCES: Heat Hater Heater Ranqe Value of I-lark.: II 7dlJ-O. BuilciinQ Pennit Info: Describe Work(Le., Build Single Fa~ilv nesidence With ~ttached Garaop) ~ ~ d-u<-~~ /. . e ~\' . .-..~ 'j;ISPECT.l~N LINE !7?6'3769 INFORlIATlDN Li~E 726-3753 Sq. Ftg. 1.lain ~q. Ftg. Access. Sq, Ftg. Other Ilew Add A lter ~ep. --Fence Demo Change/Use Other- - '\) \1'\ 10- """0 ,~ I~ Job Address 3,11,,4 Aa.+PWll.t \ ~H' Ic\; oR. Lega I Descri ption Ci1 ~ (li::ltti'l1A" cl - DwnerdfAWW, ~. I-lrtlY1P<:. :TV', Address -p() %)( an '3 S~,V\t:A~lc400 O'UJ:1 Constructi~' Phone Address Ul::.~lurl Il:.M1 (name) Phone {address) (lies. no.) lexnires) ,I {ohane no. I Primary \Jfff\ 'K1'l$.o::.., Structural Electrical Mechanical CONTRACTORS (namel (address) \lUV\ ~O ~c; ( hr~ of .-/~ Plumbina jJk..~ (ljrrJ-..- () Electrical CVu.~ fhJ. ..J6.n ..f"",~.if 1.1' JJ JJ I , ~"leiH ~ /rAA~ Genera 1 ~;\) / (pxo;res) (ohnnp nn.) PLUI1BING NO. Each single fixture Relocated building (new fix. additional) Is.F. Residence (J bath) . [DuPlex (1 bath) each IAdditional bath I ~Jater service Sewer X Storm Sewer ELECTRICAL MECHANICAL FEF f.HARr,E NO I ~~~ I n./4IH~~ NO, I I l=l=~ j nH\.lH~c:' Residence of SQ. FT. furnace/burner to BTU's c.,...-".ftew c;rcu~ts alts. or extenSlons ~ "'2 t:*'" ""i!SR.., SERVICES p- Floor furnace and vent Recessed wall ~n~rp hp~tpr ~nrl vpnt jP.- Temporary Construction Change in existing resjdence Imultifamily, camm. or IndlJc;trii'll [Of amps.[ [ COMI,I. IINO. FEEDERS [Install/alter/relocate [ dic;trih. fpprlprc; [Of amp~[ App 1; ance vent seoariltp Sta"tionarv evan. cooler" . Vent fan wi th sinole duct I'Vent system apart from heat;na or A.C. [Mechanical exhaust hood ilnd duc.t I \'}ood stove/heater [ TOTAL CHARGES /0. - TOTAL CHARGES WHERE STATE L'I~ REQUIRES that the Electrical work be done by an shall not be valiJ until the label has been signed by an Electrical I ISSUANCE OF PFR!lIT ~I TOTAL CHARGES -Electrical Contractor. the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFUllY EXM1INED the completed application for permit. and do hereby certify that all information hereon is true and correct. and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Soringfield and the laws of the State of Oregon pertaining to the work described herein. and that tm OCCUPAIKY will be made of any structure without the permission of the Building Division. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon. and that only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project. Zone Fire Zone Flood Plain Tyoe/Const. Bedrooms Stories Units Dccy Load Occy Group SIGIIATURE ~/ 4.~~ FOP. O'rFICE USE OlIL Y I Sq. Ftg.' riain ,x Value Sq, Ftn. Access~..!:>~ Value I~r-.- Sq. Ft~. Other ~_ x Value~~-- TOTAL VALUATION 75'~ ",0 DATE 8~5-Bs HAf.IE(please print) k '-WI tY-fH,ri.r-tc>J< BUILDING PERIIIT Charges and Surcharges /".... ",.._ Plan Ck. COlll11/1nd ____j.~"___._ 65%/Blda Pj'r Fpp "t> Plan Ck. Res . ' " 30%/Blda Per Fee //> Go I Fence ____L~.:.____ - YO [ D~o ____its. db I Sidewalk ,~ I A/C Paving , [Curb Cut ------------1 6.50 Systems Development Charae (1.5~) /y -#' . PLur~BING PERMIT Charges and Surcharges I I I I I I 7C:;;. yo 11 &2":' 9e.l . ELECTRICAL PERI~IT Cha rges and Surcharges 0/' t? ~ Irotal Comb; rermit flECHANICAL PERMIT Charges and . Surcharges " ~ I I TOTAL . ,. y e COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job Address B. Legal Description 1. example- Tax lot 100, lane County Map Reference 1/ 03 43 2. example- Lot I, Block 3, 2nd Addition to ~pr'ngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. example- heat/electrical ceilinqjor forced air qas 2. exa~le- waterheater/electrlcal/or solar E. Square footage or valuation, etc. - 1. example- 1250 sq. foot house, 500 sq, foot garage 2. example- if new project. check new - if addition, check add. etc. F. Building permit information: 1. example - construct single family house with an attached garage 2. example - remodel existing garage into family room 3. exa~le - convert single family residence into restaurant (change of use) G. Value of work as defined in Section 303 (a) of the Structural SpeCialty Code H. DESIGN TEAfI AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job site corrections, etc. II. Abbreviated Plumbing, Mechanical, & Electrical Schedules A. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the applicant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installed B. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division 1. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be'installed are not covered.on, the abbreviated schedules you should consult tne' full schedules C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES D. As noted on the CAP, the label must be delivered to the electrical contractor for signature by his electrical supervisor. The general contractor is.not authorized to sign the electrical label, --- III. Applicant to sign and date Whenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staff will prepare a type written copy and return it to the applicant at the time the actual permit is issued for his Signature. IV. Fees and Charges Plan check fees are due and payable at the time of the application, and no plans will be processed until these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PROJECT CONDITIONS TO BE 'SAt)SFIED BEFORE OCCUPANCY: . ':.J " PERMIT VALIDATION n) I( \ r SO .(?~ , Pennit Clerk j", ;, YUU;; .' .~ Pennit applicant exempt from registration with the Builder's Board because: Additional Project-Information: ,', .' PLANS REVIEWED BY: .' name L.:J>.R#~ ?2 ~~ si~'nature ~ _ -" . -. " ".' ~, ., ~- ~'-7 , ,. date s-~ss- ,0 ~ . . . . .' EXHIBIT "A" Beginning at 'a point 333.80 feet North 89 49' 20" East of the Southeast corner of the A. C. Stevens Donation Land Claim No. 45, Township 17 South, Range 3 West of the willamette Meridian, and run thence North 0 04' West 78.06 feet; thence South 89 49' 20" West 18.00 feet; thence North 0 04' West 78.06 feet; thence South 89 49' 20" West 18.00 feet; thence North 0 04' West 73.89 feet thence North 89 45' 20" East 100.00 feet to a point on the West right of way line of Gateway Street; thence South o 04' East 124.80 feet; thence along the arc of a 1869.86 foot radius curve to the right, the long chord of which bears South o 21' 10" Wes~ 27.37 feet; thence South 89 49' 20" West 81.80 feet to the Point of Beginning, in Lane County, Oregon. Together with the right to install and maintain necessary utilities, including but not limited to sewers, storm sewers and use of the untraveled portion for car parking purposes, over and along the following; Also a right of joint access for ingress and egress over and along the follow Beginning at the Southeast corner of the A. C. Stevens' Donation Land Claim No. 45 in Township 17 South, Range 3 West of the Willamette Meridian, and run thence North 89 49' 20" East 220 feet; thence North 0 04' West 151.95 feet to the true point of beginning; thence North 89 45' 20" East 195.80 feet to a point on the West right of way line of Gateway Street; thence North 0 04' West along said right of way line 30.00 feet; thence South 89 45' 20" West 195.80 feet; thence South 0 94' East 30.00 feet to the point of beginning, in Lane County, Oregon.